We report the case of a 6-month-old Hispanic boy with a 4-month history of widespread pruritic hypopigmented papules mimicking lichen nitidus. The final diagnosis was multisystem non-risk-organ Langerhans cell histiocytosis (LCH), with cutaneous and multiple bone involvement. With this patient and others previously reported in the literature, we suggest an early biopsy of the hypopigmented rash in children.

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A B Figure 4. (A) Low-magnification image shows the coexistence of typical nests with an underlying desmoplastic stroma. (B) Enlarged collagen fibers intermingled with melanocytes.

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